• 제목/요약/키워드: Cervical approach

검색결과 231건 처리시간 0.023초

응급실에서 자살 시도자의 치료 (The management of patient attempting suicide in the emergency room)

  • 노현정;강영준
    • Journal of Medicine and Life Science
    • /
    • 제16권3호
    • /
    • pp.60-63
    • /
    • 2019
  • The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.

흉요추부 손상 (Thoracolumbar Spine Injury)

  • 안면환
    • Journal of Yeungnam Medical Science
    • /
    • 제19권2호
    • /
    • pp.73-91
    • /
    • 2002
  • Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

  • PDF

Modified Trajectory of C2 Laminar Screw-Double Bicortical Purchase of the Inferiorly Crossing Screw

  • Rhee, Woo-Tack;You, Seung-Hoon;Jang, Yeon-Gyu;Lee, Sang-Youl
    • Journal of Korean Neurosurgical Society
    • /
    • 제43권2호
    • /
    • pp.119-122
    • /
    • 2008
  • The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.

만성 축성 경부통에 경추 다열근 평면 차단술의 유용성 (Ultrasonography-Guided Multifidus Cervicis Plane Block as a New Approach for the Treatment of Chronic Axial Neck Pain)

  • 홍준택;조한얼;박중현
    • Clinical Pain
    • /
    • 제20권1호
    • /
    • pp.30-34
    • /
    • 2021
  • Multifidus cervicis plane block has been effectively used to provide analgesia during and after cervical spine surgery, but not for any other purpose. Here, we report three cases of chronic axial neck pain unresponsive to medical treatment. We performed multifidus cervicis plane block bilaterally, which lowered numerical rating scale (NRS) score within 2 weeks. Thus, multifidus cervicis plane block is one of the novel options that may be used for chronic axial neck pain.

Plunging Ranula환자의 치험례 (A Case Report of Plunging Ranula : An unusual case of mucous extravasation cyst)

  • 이동근;권경환;김용완;이은영;김은철
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제20권3호
    • /
    • pp.241-245
    • /
    • 1998
  • The plunging ranula or cervical ranula is amucous extravasation cyst of the sublingual gland. It is slightly common in females, shows no side preference, and is more prevalent in the second and third decades of life. It typically manifests as a painless, nonmobile swelling in the neck. The pathogenesis of plunging ranula is the discontinuities of the mylohyoid muscle in a position that would allow extravasation of sublingual gland mucin. The histologic appearance is characteristically of a cyst, devoid of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophages stuffed with mucin. The correct diagnosis is essential for the most effective treatment, which is exicision of the sublingual gland. The plunging ranula must be differentiated clinically and histomorphologically from thyroglossal duct cyst, dermoid cyst, branchogenic cyst, lymphangioma, laryngocele, lipoma, hemangioma, cervial thymic cyst, cysts of the parathyroid or thyroid gland, lymphadenopathy, abscess, or tumor. We report a case and review the literatures, in our case, 23-year old man were diagnosis as plunging ranula after have been taken sialogam, MRI, etc. He underwent surgery via a cervical approach. The ranula reached the anterior neck by passing through a dehiscence in the mylohyoid muscle. A pseudocyst was extirpated. Although total sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods.

  • PDF

편측 안면신경 마비를 동반한 Eagle 증후군 치험례 (Eagle's Syndrome Presenting Unilateral Facial Nerve Palsy: Case Report)

  • 신희진;권영욱;조성민;김창현;박재억
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제32권5호
    • /
    • pp.467-472
    • /
    • 2010
  • Eagle's syndrome is the manifestation of elongated styloid process that is not a common entity in dental clinics. Without the knowledge of this syndrome misdiagnosis can be made and therefore differential diag-nosis with other diseases of oral and maxillofacial area is required. The symptoms of elongated styloid process are cervical pain, foreign body sensation, dysphagia and pharyngeal pain. A 27 years old male vis-ited our hospital. He had cervical pain with unilateral facial nerve palsy. Along with meticulous clinical examinations, 3D-CT, Plain radiographic studies were used to make the diagnosis. In computed tomogra-phy, Lt. styloid process was elongated and fractured. Patient have undergone surgical resection of elongat-ed styloid process and have been carefully observed. Characteristically, preoperative facial nerve palsy showed rapid postoperative recovery. The other clinical symptoms that were present in the initial visit were diminished. The purpose of this article is to report a case of Eagle's syndrome presenting unilateral facial nerve palsy that was treated with transoral surgical approach with literature review.

편도주위농양에 합병된 하행 괴사성 종격동염 -치험 1례- (Descending Necrotizing Mediastinitis Secondary to Peritonsillar Abscess -A Case Report-)

  • 최필조;이용훈;우종수;이기남;손춘희;박헌수;이인규
    • Journal of Chest Surgery
    • /
    • 제32권7호
    • /
    • pp.686-689
    • /
    • 1999
  • 하행 괴사성 종격동염은 구강인두와 경부 염증의 드문 합병증 중의 하나로서, 높은 사망률과 합병증 등을 낮추기 위해 조기에 적극적이고 효과적인 수술적 배농술이 필요하다. 39세 남자 환자가 연하통, 경부 종창, 연하곤란 및 호흡곤란으로 내원하여 촬영한 경부 CT상 편도주위농 양과 인두 후부 및 주위의 농양이 발견되어 이비인후과에서 경부절개를 통한 배농술을 시행하였다. 1차 수 술 이후에 발열, 양측 견갑통이 재발하였으며 재촬영한 경부 및 흉부 CT에서 종격동 농양이 발견되어 경부 배농술과 더불어 개흉술을 통한 종격동 배농술을 시행하였다. 수술시에 시행한 종격동 농양과 농흉, 그리고 객담으로부터의 균배양 결과 Klebsiella pneumona로 밝혀졌다. 2차 수술후 환자는 호전되어 술후 85일째 퇴원 할 수 있었다. 결론적으로 CT촬영으로 하행 괴사성 종격동염을 조기에 진단하고 경부 배농술 뿐만 아니라 개흉술을 통한 광범위하고 효과적인 배농술이 환자의 생존율을 높이는데 도움이 되리라 본다.

  • PDF

ASCUS 환자에서 고위험 사람유두종바이러스 검사와 자궁경검사의 유용성 (The Usefulness of Concomitant High-Risk Human Papillomavirus Test and Colposcopy in Combination with the Papanicolaou Test in ASCUS Patients)

  • 김민경;손진희;김철환;최종상
    • 대한세포병리학회지
    • /
    • 제16권1호
    • /
    • pp.18-24
    • /
    • 2005
  • The objective of this study was to ascertain whether or not the high-risk human papillomavirus (HPV) test, when coupled with Papanicolaou (Pap) smears, would prove useful in the screening and management of patients in whom abnormal Pap smear results had been obtained. Concomitant high-risk HPV detection using the hybrid capture II test and colposcopy with a Pap smear were performed with 176 patients, all of whom had been screened for both cervical carcinoma and precancerous lesions. We concomitantly performed colposcopies on these patients. Upon the follow-ups, the histologic diagnoses of these patients were confirmed via either biopsy or hysterectomy. The rate of high-risk HPV detection was correlated with cytologic diagnoses and colposcopic findings. The group composed of the high-risk HPV-positive ASCUS patients exhibited a 55.7% rate of cervical intraepithelial neoplasia (CIN), a significantly higher rate than the 7.5% result obtained in the high-risk HPV-negative ASCUS group. HPV test showed high sensitivity (87%) and low specificity (62.6%) in detection of CIN and colposcopy also showed high sensitivity (88%) and low specificity (22%). Any combination of these tests improve sensitivity, but not specificity. High-risk HPV tests, when coupled with Pap smears, constituted a useful triage approach with regard to colposcopy-directed biopsies in patients in whom a cytologic diagnosis of ASCUS had been rendered.